SYMPTOMTOLOGY OF CARDIOVASCULAR

DISEASES

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SYMPTOMTOLOGY OF CARDIOVASCULAR

DISEASESDYSPNEACHEST PAINPALPITATIONSDIZZINESS & SYNCOPEPERIPHERAL EDEMASYSTEMIC SYMPTOMS

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SYMPTOMTOLOGY OF CARDIOVASCULAR DISEASES

1)DYSPNEADEFINITION ONSET Sudden

Ac. LVF H.T. M.I.Arrhythmia

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DYSPNEAOnset- cont

GradualH.T.IHDVHDFluid overload

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DYSPNEA-cont

AGGRAVATING FACTORS RELIEVING FACTORS ORTHOPNEA Dyspnea on lying flat PND Dyspnea occurs suddenly ½ hr. to 4 hr.

after going to bed & is relieved after 10 –20 minutes

PAROXYSMAL NOCTURNAL DYSPNEA

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DYSPNEA-cont

NEW YORK HEART ASSOCIATION CLASSIFICATION

GRADE-1 No breathlessnessGRADE-2 Breathlessness on moderate

exertionGRADE-3 Breathlessness on mild

exertionGRADE-4 Breathlessness at rest

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Symptomtology- cont

2) CHEST PAIN OR DISCOMFORTANGINA PECTORISM.I.PERICARDITISAORTIC DISSECTIONMISCELLANEOUS CAUSES

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CHEST PAIN. Cont

1)ANGINA PECTORISCardiac pain due to myocardial ischemia

SITERADIATIONDURATIONCHARACTERAGGRAVATING FACTORRELIEVING FACTORSASSOCIATED SYMPTOMS

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Chest pain-ANGINA. Cont1)SITE & RADIATION

CENTRALOPEN HAND OR FIST(rather than

pinpoint)EPIGASTRICL- ARM,BOTH ARMS, JAW

SITE & RADIATION OF ANGINA

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Chest pain-ANGINA. Cont

2)DURATION & AGGRAVATING & RELIEVING FACTORS

5-20 minutesExertionExcitementColdExercise after mealFunctional activityRestGTN

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Chest pain-ANGINA. Cont

CANADIAN CARDIOVASCULAR SOCIETY- FUCTIONAL CLASSIFICATION

Grade-1 No limitation

Grade-2 Slight limitation

Grade-3 Marked limitation

Grade-4 Pain at rest

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Chest pain-ANGINA. Cont

3)CHARACTERDiscomfort rather than painTightnessHeaviness

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Chest pain-ANGINA. Cont

4)ASSOCIATED SYMPTOMS

Dyspnea

Sweating

Vomiting Usually absent

Nausea

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Chest pain-ANGINA. Cont

TYPES OF ANGINAEFFORT ANGINAUNSTABLE ANGINADECUBITUS ANGINACRESCENDO ANGINA

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Chest pain-ANGINA. Cont

ATYPICAL SYMPTOMS

Risk factors

Age

Sex

Smoking

H.T.

Diabetes

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Chest pain -cont

B ) MYOCARDIAL INFARCTIONSITE & RADIATIONSEVERITYDURATIONPPT. FACTORSRELIEVING FACTORSASSOCIATED SYMPTOMSPAINLESS M.I.

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Chest pain -cont

C-PERICARDITISMore localized(Central or lateral chest wall)Sharp-Stabbing or rawNo radiationChanges with breathing & postureImproves with NSAID’SPreceded by viral illness

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Chest pain -cont

D-AORTIC DISSECTIONH/O H.T., Marfans synd,Aortic

aneurysm,Chest traumaSuddenCentral –b/w scapulaeTearingAssociated features

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Chest pain -cont

E- MISCELLANEOUS CHEST PAIN CAUSES

Precordial catch (Da-Costa’s synd.)M.V.P.

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Symptomtology- cont

C- PALPITATIONSAwareness of heart beatSINUS RHYTHMSUSTAINED ABNORMAL RHYTHMOCCASIONAL IRREGULARITIES OF

RHYTHMAll patients of arrhythmia may not be

symptomatic(A.F.)

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PALPITATIONS-cont

ASK ABOUT:Onset & terminationTriggering factors

ExerciseAlcoholCaffeineAnxiety

FrequencyDuration of attackRhythmAssociated features

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PALPITATIONS-cont

a) Palpitations in sinus rhythmEXERCISEANXIETYSTRESSCAFFIENESMOKINGNIGHT TIME

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PALPITATIONS-cont

b) SUSTAINED ABNORMAL RHYTHMSuddenMinutes to hoursUnrelated to anxietyASK ABOUT:

Family h/o sudden deathPast h/o I.H.D.Drugs

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PALPITATIONS-cont

c) ECTOPIC BEATS

Felt as missed beatsVentricular

Benign in 10-15 %At restDisappear with exercise

Atrial

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Symptomtology- cont

4)SYNCOPE & DIZZINESSDizziness- non cardiacSyncopePre-syncope CARDIAC

Cardiac causes of syncopePostural hypotentionArrhythmiaL.V. Outflow obstruction

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Syncope- cont

1)Postural hypotentionDefinitionDrugsDehydrationA.N. Neuropathy

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Syncope- cont

2)ArrhythmiasBradyarrythmias

Sick sinus synd.CHBDrugs

Ventricular tachycardias

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Syncope- cont

3)L.V. Outflow obstrucitonSevere A.S.H.O.C.M.

4)Other cardiac causesEnhanced vagal sensitivity(Bradycardia + Vasodilatation)

Fright Fear Micturition Cough

Carotid sinus hypersensitivity Uncommon Elderly Atrial myxoma

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Symptomtology- cont

5)PERIPHERAL EDEMASymptomSignANKLEUnilateral

DVTCellulitesTraumaHemiplegia

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Edema- cont.

BilateralCCFHypoprotenemiaLymph. ObstructionI.V.C. obstructionImmobility

SACRALGENERALISED

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Symptomtology- cont

6)SYSTEMIC SYMPTOMSa) Fatigue

Heart failure Sustained arrhythmia Cyanotic heart disease Drugs

b)Anorexia

THE END